Malignant melanoma of skin
In Melanoma and other malignant neoplasms of skin (C43-C44), chapter 2: Neoplasms
24 billable codes under C43: none are a CC or MCC; all map to HCC 23 (Prostate, Breast, and Other Cancers and Tumors).An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Rules for coding benign and malignant neoplasms: using the Neoplasm Table, sequencing primary and secondary sites, treatment encounters, complications, and current cancer versus personal history.
- Admission/Encounter for treatment of primary site (page 33)
- Admission/Encounter for treatment of secondary site (page 33)
- Coding and sequencing of complications (page 34)
- Primary malignancy previously excised (page 34)
- Admissions/Encounters involving antineoplastic chemotherapy, immunotherapy and radiation therapy (page 35)
- Admission/encounter to determine extent of malignancy (page 36)
- Symptoms, signs, and abnormal findings listed in Chapter 18 associated with neoplasms (page 36)
- Admission/encounter for pain control/management (page 36)
All codes under C43
C43 can't be used on a claim. Pick a billable code below; grey headings group them.
- C43.0Malignant melanoma of lip
- C43.1Malignant melanoma of eyelid, including canthus
- C43.10Malignant melanoma of unspecified eyelid, including canthus
- C43.11Malignant melanoma of right eyelid, including canthus
- C43.111Malignant melanoma of right upper eyelid, including canthus
- C43.112Malignant melanoma of right lower eyelid, including canthus
- C43.12Malignant melanoma of left eyelid, including canthus
- C43.121Malignant melanoma of left upper eyelid, including canthus
- C43.122Malignant melanoma of left lower eyelid, including canthus
- C43.2Malignant melanoma of ear and external auricular canal
- C43.20Malignant melanoma of unspecified ear and external auricular canal
- C43.21Malignant melanoma of right ear and external auricular canal
- C43.22Malignant melanoma of left ear and external auricular canal
- C43.3Malignant melanoma of other and unspecified parts of face
- C43.30Malignant melanoma of unspecified part of face
- C43.31Malignant melanoma of nose
- C43.39Malignant melanoma of other parts of face
- C43.4Malignant melanoma of scalp and neck
- C43.5Malignant melanoma of trunk
- C43.51Malignant melanoma of anal skin
- C43.52Malignant melanoma of skin of breast
- C43.59Malignant melanoma of other part of trunk
- C43.6Malignant melanoma of upper limb, including shoulder
- C43.60Malignant melanoma of unspecified upper limb, including shoulder
- C43.61Malignant melanoma of right upper limb, including shoulder
- C43.62Malignant melanoma of left upper limb, including shoulder
- C43.7Malignant melanoma of lower limb, including hip
- C43.70Malignant melanoma of unspecified lower limb, including hip
- C43.71Malignant melanoma of right lower limb, including hip
- C43.72Malignant melanoma of left lower limb, including hip
- C43.8Malignant melanoma of overlapping sites of skin
- C43.9Malignant melanoma of skin, unspecified
C43 MS-DRGs
As the principal diagnosis, the billable codes under C43 group to MS-DRG 595, 596, 124, 125, 606, or 607 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 595 Major Skin Disorders with MCC (19 of 24 codes)
- DRG 596 Major Skin Disorders without MCC (19 of 24 codes)
- DRG 124 Other Disorders of the Eye with MCC or Thrombolytic Agent (5 of 24 codes)
- DRG 125 Other Disorders of the Eye without MCC (5 of 24 codes)
- DRG 606 Minor Skin Disorders with MCC (1 of 24 codes)
- DRG 607 Minor Skin Disorders without MCC (1 of 24 codes)
Other codes that refer to C43
Notes on these codes point to C43.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Melanoma
Melanoma is the most serious type of skin cancer. Often the first sign of melanoma is a change in the size, shape, color, or feel of a mole. Most melanomas have a black or black-blue area. Melanoma may also appear as a new mole. It may be black, abnormal, or "ugly looking."
Read more about melanoma on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.